title: Recurrence of esophageal cancer after R0 surgery. Risk factors and evolution.
abstract: BACKGROUND
  despite advances in surgical and adjuvant therapy, recurrence in esophageal cancer submitted to R0 surgery remains high. The aim is to define risk factors and recurrence patterns. Additionally, to show the management carried out and the outcome of patients showing recurrence.
  
  
  METHODS
  observational and prospective study that included 61 patients. Neoadjuvancy therapy was indicated on T3, T4 and N+ tumors and every lymph node dissection was performed in two fields. Recurrence is defined at distance, regional or local, when, recurrence is detected after six months. According to clinical features and the recurrences, a palliative, chemotherapeutic or surgical management was indicated.
  
  
  RESULTS
  there were 54 men and the mean age was 59.7 years. The most frequent stage was the IIA and 17 (27.9%) had positive lymph nodes. Thirty (49.2%) had showed recurrence with a median disease-free interval of 10.5 months. The pTNM, the absence of response to the neoadjuvancy and the presence of compromised lymph nodes were found to be risk factors for recurrence. Only the presence of compromised lymph nodes was significant in the multivariate analysis. After diagnosis of the recurrence, median survival was 7 months and 6 subjects survived beyond 1 year.
  
  
  CONCLUSIONS
  we confirmed the high incidence of recurrence in esophageal cancer, where the presence of compromised lymph nodes is probably the main risk factor. After the diagnosis of a relapse the prognosis would be bad, however there would be a small subsidiary group for treatment where outcomes would be better.
authors.forename: Javier
authors.initials: J
authors.lastname: López-Sebastián
authors.forename: Roberto
authors.initials: R
authors.lastname: Martí-Obiol
authors.forename: Fernando
authors.initials: F
authors.lastname: López-Mozos
authors.forename: Joaquín
authors.initials: J
authors.lastname: Ortega-Serrano
mesh_terms: D004938:Esophageal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome